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Prolonged suppressive antibiotic therapy for infected orthopedic prostheses
J Segreti1, J A Nelson, G M Trenholme
1Rush Medical College, Chicago, Illinois 60612, USA.
Summary
Prolonged antibiotic suppression offers a viable alternative to orthopedic prosthesis removal for select patients with infected implants. This approach demonstrated a good response rate, allowing patients to retain functional prostheses.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Pharmacology
Background:
- Infected orthopedic prostheses pose a significant clinical challenge.
- Surgical removal is the traditional treatment, but carries risks and morbidity.
- The efficacy of prolonged suppressive antibiotic therapy remains incompletely defined.
Purpose of the Study:
- To evaluate the effectiveness of prolonged suppressive antibiotic therapy in patients with infected orthopedic prostheses.
- To determine the outcomes and complication rates associated with this treatment strategy.
Main Methods:
- Retrospective review of 18 patients with infected orthopedic prostheses treated over 10 years.
- All patients underwent surgical debridement and prosthesis retention.
- Treatment involved initial intravenous antibiotics (6-8 weeks) followed by long-term oral antibiotic suppression.
Main Results:
- Fifteen of 18 patients (83%) achieved a favorable outcome, retaining a functional prosthesis.
- Complications related to antibiotic suppression occurred in 22% of patients but did not require treatment cessation.
- No patients required prosthesis removal due to treatment failure.
Conclusions:
- Prolonged antibiotic suppression is a reasonable and effective alternative to surgery for selected patients with infected orthopedic prostheses.
- This approach can help preserve functional prostheses and avoid major surgical intervention.
- Careful patient selection and monitoring are crucial for successful outcomes.